MRS. IRENNE MAGOULAS (NPI# 1558543975) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558543975 |
| Entity Type | Individual |
| Full Name | MRS. IRENNE MAGOULAS |
| Credential | L.C.S.W. |
| Practice Address |
2264 Green Hill Rd Sebastopol CA 95472-9034 |
| Mailing Address |
Po Box 751026 Petaluma CA 94975-1026 |
| Practice Telephone | 7078235019 |
| Mailing Telephone | 7077999915 |
| Enumeration Date | 2007-11-27 |
| Last Update Date | 2007-11-27 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
22595 | CA | Behavioral Health & Social Service Providers |
| Street Address |
2264 GREEN HILL RD |
| City | SEBASTOPOL |
| State | CA |
| Zip Code | 95472-9034 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568517050 | The Camp Recovery Center, LLC | Substance Abuse Rehabilitation Facility | 2264 Green Hill Rd, Sebastopol, CA 95472-9034 | 2007-01-24 |
| 1043843899 | The Camp Recovery Center, LLC | Substance Abuse Rehabilitation Facility | 2264 Green Hill Rd, Sebastopol, CA 95472-9034 | 2020-02-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558916791 | Mellisa Nicole Elrod | Occupational Therapist | 1935 Gravenstein Hwy, Sebastopol, CA 95472 | 2019-08-05 |
| 1457820987 | Isabel Brooke Martinez | Acupuncturist | 961 Gravenstein Hwy South, # 100, Sebastopol, CA 95472 | 2018-11-14 |
| 1275025470 | Shahbano Syeda | Specialist/Technologist | 846/848 Gravenstein Hwy South, Sebastopol, CA 95472 | 2018-06-04 |
| 1467990812 | Mathew Metzgar | Marriage & Family Therapist | 1800 N. Gravenstein Hwy, Sebastopol, CA 95472 | 2017-02-06 |
| 1760939318 | Andrea Kirk | Psychologist | 876 Gravenstein Hwy S., Suite 6, Sebastopol, CA 95472 | 2016-09-01 |
| 1548629371 | Stacy Simons | Massage Therapist | 103 Morris St Ste V, Sebastopol, CA 95472 | 2016-02-22 |
| 1619341880 | Carol Schmid | Counselor | 1800 N, Gravenstein Hwy, Sebastopol, CA 95472 | 2015-11-25 |
| 1801273727 | Aaron Martinez | Specialist/Technologist | 7441 Witter Road, Sebastopol, CA 95472 | 2015-04-29 |
| 1699167049 | Nia Kaye | Marriage & Family Therapist | 130 Petaluma Ave Ste 2c, Sebastopol, CA 95472 | 2015-02-23 |
| 1497091383 | Caitlin Marie Kirkman | Midwife | 5611 Hessel Ave, Sebastopol, CA 95472 | 2012-12-20 |
| Find all providers in zip 95472 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942839881 | Shanna Donald | Social Worker | 32 Underwood Street, Sebastopol, MS 39359 | 2020-04-03 |
| 1881943298 | Julia Glanz | Social Worker | 101 Morris Street, Suite 207, Sebastopol, CA 95472 | 2012-08-30 |
| 1932439403 | Tina Stanley | Social Worker | 934 Gaydee Ct, Sebastopol, CA 95472-4611 | 2010-01-06 |
| 1124152186 | Brian G Stricker | Social Worker | 6800 Palm Ave Ste C, Sebastopol, CA 95472-4269 | 2007-03-14 |
| 1750413001 | Michelle Anne Miller | Social Worker | 6741 Sebastopol Ave, Ste 230, Sebastopol, CA 95472-3838 | 2007-03-12 |
| 1497779425 | Brian Paul Jacobs | Social Worker | 339 S Main St, Sebastopol, CA 95472-4208 | 2006-07-26 |
| 1467470518 | Marcia Katz | Social Worker | 101 Morris St, Suite 207, Sebastopol, CA 95472-3836 | 2006-07-17 |
| 1487978011 | Elizabeth Marie Jimenez | Social Worker | 1800 Gravenstein Hwy N, Sebastopol, CA 95472-2607 | 2010-03-25 |
| 1912040445 | Amy Herrema Chevrolet | Social Worker | 435 Petaluma Ave, Suite 110, Sebastopol, CA 95472 | 2007-02-15 |
| 1982796371 | Paul Gustav Tamminen | Social Worker | 435 Petaluma Ave, Suite 140, Sebastopol, CA 95472-4277 | 2006-09-29 |
| Find all providers in SEBASTOPOL | ||||
| City | SEBASTOPOL |
| Zip Code | 95472 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.